side effects

Last reviewed 01/2021

Side effects of ACE inhibitors include:

  • first-dose hypotension:
    • increased risk in patients treated for heart failure, dehydration or on diuretics
  • persistent dry cough:
    • occurs in up to 20% of patients
    • more frequent in women and non-smokers
    • occurs in repetitive bouts, especially at night, and may precipitate vomiting and voice changes
    • diagnosed by effect of stopping/reducing drug, CXR and peak flow diary to exclude other causes
    • do not treat with antitussives; NSAID's may be beneficial
    • withdraw ACEI if symptoms intolerable
  • sore mouth, throat discomfort, loss of taste and voice changes
  • abdominal pain
  • rash
  • angioedema
  • hyperkaemia, proteinuria, thrombocytopenia, agranulocytosis, neutropenia - all more common in pre-existing renal impairment
  • abnormal liver function test, cholestatic jaundice and liver damage
  • renal impairment
  • hypoglycaemia